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A Situation-Specific Theory of End-of-Life Communication in Nursing Homes

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  • Silvia Gonella

    (Direction of Health Professions, City of Health and Science University Hospital of Torino, Corso Bramante 88-90, 10126 Turin, Italy
    Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy)

  • Sara Campagna

    (Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy)

  • Valerio Dimonte

    (Direction of Health Professions, City of Health and Science University Hospital of Torino, Corso Bramante 88-90, 10126 Turin, Italy
    Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy)

Abstract

High-quality end-of-life communication between healthcare professionals (HCPs), patients and/or their family caregivers (FCs) improves quality of life and reduces non-beneficial care at the end of life. Nursing homes (NHs) are among the contexts at the forefront of these conversations. Having a solid theoretical basis for the role of end-of-life communication in NHs in transitioning to palliative-oriented care can offer indications for research, practice, education, and policy related to geropalliative care. This study aimed to develop a situation-specific theory of end-of-life communication in NHs by refining an existing theory. A four-step integrative approach was employed that included: (1) checking the assumptions for theorization; (2) exploring the phenomenon through multiple sources; (3) theorizing; and (4) reporting. All elements of the existing end-of-life communication theory in NHs were confirmed: end-of-life communication improved the understanding of FCs about their relatives’ health conditions, shared decision-making, and reflections on the desired preferences of residents/FCs for care at the end of life. Furthermore, the family environment affected the burden of FCs in the decision-making process. Finally, time and resource constraints, regulations, visitation restrictions due to the COVID-19 pandemic, and social and cultural values influenced the quality and timing of communication. The study findings confirmed the impact of the political, historical, social, and cultural context on end-of-life communication, thus providing the basis for a situation-specific theory.

Suggested Citation

  • Silvia Gonella & Sara Campagna & Valerio Dimonte, 2023. "A Situation-Specific Theory of End-of-Life Communication in Nursing Homes," IJERPH, MDPI, vol. 20(1), pages 1-22, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:1:p:869-:d:1023601
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    References listed on IDEAS

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    1. Joanna Broad & Merryn Gott & Hongsoo Kim & Michal Boyd & He Chen & Martin Connolly, 2013. "Erratum to: Where do people die? An international comparison of the percentage of deaths occurring in hospital and residential aged care settings in 45 populations, using published and available stati," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(2), pages 327-327, April.
    2. Nathan Davies & Tanisha De Souza & Greta Rait & Jessica Meehan & Elizabeth L Sampson, 2021. "Developing an applied model for making decisions towards the end of life about care for someone with dementia," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-20, May.
    3. Joanna Broad & Merryn Gott & Hongsoo Kim & Michal Boyd & He Chen & Martin Connolly, 2013. "Where do people die? An international comparison of the percentage of deaths occurring in hospital and residential aged care settings in 45 populations, using published and available statistics," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(2), pages 257-267, April.
    4. Silvia Gonella & Paola Di Giulio & Alexandra Antal & Nicola Cornally & Peter Martin & Sara Campagna & Valerio Dimonte, 2022. "Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study," IJERPH, MDPI, vol. 19(5), pages 1-18, February.
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